Why this grade
This listing scored 66/100, which is a C. It lost the most ground on pay transparency.
- Description depth 20 / 20 How much the posting actually says about the work, measured in characters of real text.
- Freshness 15 / 15 How recently it was posted. Older postings are likelier to be filled or abandoned.
- Pay transparency 12 / 25 A published salary range, worth more than any other single factor because it is what a candidate cannot find out without applying.
- Remote clarity 8 / 15 Whether "remote" means anywhere, or is quietly restricted to one country.
- Role specificity 6 / 10 Whether the listing is tagged well enough to tell what the role actually is.
- Corroboration 5 / 10 Whether more than one source carries this listing.
Every figure above is arithmetic over the posting itself — its salary field, its text, its age, its tags and how many sources carry it. How the grades work →
This listing does not state a salary
$88k – $150k
That is the middle half of what comparable roles paid on this board over the last 90 days — 50 listings that did publish a figure, median $125k. It is not this employer's offer, and we have no idea what they pay. It is only what the rest of the market advertised.
Senior Full Time
JOB DESCRIPTION Job Summary
Provides lead level support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims.
Essential Job Duties
- Coordinates workflow and staffing of day-to-day claims adjudication activities, and assigns and monitors work of staff to ensure adherence to productivity and quality standards.
• Manages escalations within the claims department by ensuring appropriate accountability, sense of urgency, communication and follow-through to closure.
• Performs daily claims troubleshooting procedures to support provider claims function as needed.
• Participates in or leads quality improvement efforts to improve claims processes and/or policies.
• Serves as provider claims subject matter expert; provides feedback to team and facilitates training as needed.
• Reviews claims deficiencies and makes recommendations to increase efficiencies and provider satisfaction.
• Sets standard with team for exemplary customer service delivery and ensures the team is meeting established claims metrics and compliance measures.
• Partners with stakeholders and leaders in other functions to coordinate provider claims-related problem-solving in an effective and timely manner.
• Provides technical claims expertise to peers and handles complex provider calls.
• Assists with training needs of claims department staff.
• Assists leadership with claims staff development.
• Recognizes trends and patterns in call and claims types and engages leadership with suggested solutions.
• Meets department quality and production standards.
• Supports all claims department initiatives to improve overall efficiency.
• Completes claims projects as assigned.
Job Qualifications
REQUIRED EDUCATION:
Associate’s Degree or equivalent combination of education and experience
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
Minimum 3 years as a Provider Claims Adjudicator
Previous claims adjusting experience as well and customer services, problem solving, critical thinking skills and research and resolution skills.
Strong attention to detail
Strong analytical skills
PREFERRED EDUCATION:
Bachelor’s Degree or equivalent combination of education and experience
PREFERRED EXPERIENCE:
6+ years previous claims adjusting and customer services experience
PHYSICAL DEMANDS:
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Originally posted on Himalayas
Apply for this role Opens himalayas.app — the link as listed; we have not yet verified it is the employer's own page
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Where this listing came from
- 04 Oct 2026 Himalayas first sighting
Seen on 1 board over 0 days.